Green Door Therapy LLC
Counselor, Mental Health in Elmhurst, IL. Organization (NPI-2).
NPI number1982195301
StatusActive
Last updated in NPPESNov 9, 2021
Details
- NPI
- 1982195301
- Entity type
- Organization (NPI-2)
- Legal business name
- Green Door Therapy LLC
- Organization subpart
- No
- Enumeration date
- May 21, 2018
- Certification date
- Nov 9, 2021
- Last updated
- Nov 9, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
126 N York St Ste 2Elmhurst, IL 60126-2888
Phone 163-038-4956
Mailing address
Po Box 7109Villa Park, IL 60181-7109
Authorized official
Brooke Madera
Clinical Therapist/ Supervisor
6303849560
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